Abstract
Abstract 12727: Impact of Initial Thrombocytopenia on Short and Midterm Outcomes in Patients With Acute Coronary Syndrome Who Underwent Percutaneous Coronary Intervention
Circulation (New York, N.Y.), Vol.138(Suppl_1 Suppl 1), pp.A12727-A12727
11/06/2018
Abstract
BackgroundPatients with thrombocytopenia presenting with acute coronary syndromes (ACS) are treated by dual antiplatelet therapy in addition to percutaneous coronary interventions. Our aim was to evaluate the impact of thrombocytopenia on bleeding, major adverse cardiovascular and cerebrovascular events (MACCE) in acute coronary syndrome patients.MethodsWe collected data of 254 patients between 2015 and 2017, 2 years retrospectively and 1 year prospectively. Patients were divided into 2 groupsGroup 1 included patients with initial thrombocytopenia (n=123) and group 2 included patients with initial normal platelet count (n=131). Thrombocytopenia was defined as a platelet count less than or equal 150.000/mL. Patients were followed up for at least 6 months and a maximum of 42 months. Endpoints were death, recurrent myocardial infarction, cerebrovascular stroke, target or non-target vessel revascularization, heart failure and bleeding.ResultsGroup 1 patients were significantly older, more likely to have history of acute coronary syndrome (38.2% versus 26.7%, p = 0.049), and more likely to present as non ST elevation myocardial infarction (NSTEMI) (39% versus 26.7%, p = 0.037). All patients in group I had platelet counts between 100,000 and 150,000/ml (mild thrombocytopenia). In hospital outcome showed significantly higher risk of cumulative MACCE in group 1 (12.2% versus 2.3%, p = 0.002) and a similar result was found after at least 6 months follow up (19.3% versus 9.6%, p=0.041). There was no significant difference between both groups regarding bleeding and heart failure outcomes.Multivariable regression modeling showed that thrombocytopenia contributed to higher incidence of in hospital MACCE (P = 0.038). However, it did not show any statistical difference in MACCE after the 6 months follow up.ConclusionsPatients with initial mild thrombocytopenia presenting with acute coronary syndrome had similar bleeding risk in comparison to patients with normal platelet count during the hospital stay and after 6 months of follow up. However, they had a higher risk of in hospital MACCE. Hence, patients with mild thrombocytopenia should be managed in a traditional fashion without any overt concerns about bleeding. However, these data need further evaluation in patients with lower platelet counts (less than or equal 100,000/ml).
Details
- Title: Subtitle
- Abstract 12727: Impact of Initial Thrombocytopenia on Short and Midterm Outcomes in Patients With Acute Coronary Syndrome Who Underwent Percutaneous Coronary Intervention
- Creators
- Ola Abdelkarim - Alexandria UniversityMohamed SadakaSherif WagdyMohamed Sobhy
- Resource Type
- Abstract
- Publication Details
- Circulation (New York, N.Y.), Vol.138(Suppl_1 Suppl 1), pp.A12727-A12727
- Publisher
- by the American College of Cardiology Foundation and the American Heart Association, Inc
- ISSN
- 0009-7322
- eISSN
- 1524-4539
- Language
- English
- Date published
- 11/06/2018
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984757270302771
Metrics
1 Record Views